License holder summary

Mallory Elizabeth Wanicki is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Mallory Elizabeth Wanicki is Highland IN 46322-3051. This licensed professional license is not current. The license was granted 09/13/2010 and expired on 03/13/2011.

Indiana

Professional Licensing Agency

Mallory Elizabeth Wanicki
Radiology Provisional Permit
License number
XP502841
Date granted
09/13/2010
Date expires
03/13/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Highland IN 46322-3051
indianalicensing.org
ID 8491993
LAST UPDATED 2024-03-02 06:23:37 UTC

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